Transjugular Intrahepatic Portosystemic Shunt Placement for Variceal Bleeding: Predictors of Mortality

Carlos E. Encarnacion, Julio C. Palmaz, Frank J. Rivera, Oscar A. Alvarez, Kedar N. Chintapalli, James D. Lutz, Stewart R. Reuter

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Purpose: To identify factors that predict survival in patients with variceal bleeding who have undergone transjugular intrahepatic portosystemic shunt (TIPS) placement. Patients and Methods: TIPS was performed in 64 of 65 patients. Indications were bleeding esophagogastric varices in 64 patients and hemorrhoidal bleeding in one. Child-Pugh classifications were A in two patients, B in 32, and C in 31. Acute bleeding was controlled before TIPS in 26 patients in stable condition but not in 39 patients whose condition was unstable. Results: Twelve patients died within 30 days of TIPS, and another 14 died thereafter. The cumulative survival rate was 67% at 6 months and 56% at 1 year. Cumulative 30-day survival was 96% for stable and 69% for unstable patients, a significant difference (P = .0135). Thirty-day survival was 91% for patients in Child-Pugh classes A and B combined and 71% for patients in class C (P = .042). Conclusion: Efforts to control acute bleeding and improve a patient's metabolic status before TIPS are likely to improve 30-day survival.

Original languageEnglish (US)
Pages (from-to)687-694
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume6
Issue number5
DOIs
StatePublished - Sep 1995

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Keywords

  • Esophagus, varices, 71.75
  • Hypertension, portal, 957.711
  • Shunts, portosystemic, 957.453
  • Stomach, varices, 72.75

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Encarnacion, C. E., Palmaz, J. C., Rivera, F. J., Alvarez, O. A., Chintapalli, K. N., Lutz, J. D., & Reuter, S. R. (1995). Transjugular Intrahepatic Portosystemic Shunt Placement for Variceal Bleeding: Predictors of Mortality. Journal of Vascular and Interventional Radiology, 6(5), 687-694. https://doi.org/10.1016/S1051-0443(95)71165-4